T tube intubation in the management of seriously ill patients with oesophagopleural fistulae.
Ten patients referred late with oesophagopleural fistulae were managed by T tube intubation of the oesophageal defect. Seven survived and six had radiographic evidence of closure of the defect. One patient who removed his T tube early was discharged to convalesce with a small oesophagocutaneous fistula. Three patients died as a consequence of pre-existing renal failure, upper gastrointestinal haemorrhage and adult respiratory distress syndrome. Patients presenting late with multisystem complications and ongoing sepsis secondary to oesophagopleural fistulae pose a major management problem. Our preliminary results suggest that T tube intubation offers a potential alternative to major surgical intervention, when more conservative measures have failed.
Naylor
A R
AR
Thoracic Surgery Unit, City Hospital, Edinburgh, UK.
Walker
W S
WS
Dark
J
J
Cameron
E W
EW
D058186:Acute Kidney Injury / Q000150:complications; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications; D004937:Esophageal Fistula / Q000601:surgery*; D004947:Esophagus; D005260:Female; D005402:Fistula / Q000601:surgery*; D006801:Humans; D007440:Intubation; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000601:surgery*; D011183:Postoperative Complications; D012131:Respiratory Insufficiency / Q000150:complications